Rotator Cuff Strengthening

Rotator cuff strengthening is vital due to the unique role played by the rotator cuff in shoulder stability.

Strengthening should be undertaken by everyone as a method of preventing injury. It is even more important to anyone who has already suffered a rotator cuff injury.

In this section I want to cover rotator cuff strengthening in a little detail and explain how it is achieved. I am going to explain about the different types of muscle actions and how they all play a part in exercises to strengthen rotator cuff muscles.

In my own mind I look on undertaking rotator cuff strength exercises as the final part of rotator cuff healing. You have had a tear or surgery, had some therapy, done the rehab and now it is time for rotator cuff strengthening.

Undertaking exercises to strengthen rotator cuff muscles will stabilise the whole shoulder joint. The majority of rotator cuff injuries actually occur because the muscles are not sufficiently strong. Strengthening is the best chance you can give yourself of staying problem and pain free.

As you will appreciate strength training is a huge subject and I only intend to cover the major points. Hopefully I can give you an understanding of the basic principles. This will then enable you to slowly and steadily build up your own range of rotator cuff strength exercises.

Training muscles to become stronger

As a general rule, a muscle increases in strength when trained close to its current force generating capacity.

What does that actually mean in practice well put simply it means any muscle to get stronger must be worked close to what it is already capable of. For example anyone who can bench press 100lbs is not going to gain strength by bench pressing 40lbs.

One further point to note is that overload intensity (the level of tension placed on muscle) is much more important in gaining strength than the actual exercise itself. There are two main muscle actions when muscle training and each can be used in cuff strengthening.

There is dynamic muscle action, when the muscle length changes, that can be split into concentric action and eccentric action. Then there is also Isometric action when the muscle is loaded but does not change length.

Dynamic - Concentric muscle action

Concentric muscle action is when the muscle shortens and joint movement occurs as tension develops.

An example is say you holding a weight in your hand, your arm is relaxed and stretched out by your side.

You slowly begin to lift the weight using your bicep muscle. This moves the arm from an extended to a flexed elbow position.

The bicep muscle has performed a shortening or concentric action moving the arm.

Dynamic - Eccentric muscle action

Eccentric muscle action is basically the opposite of Concentric.

It occurs when external resistance exceeds muscle force and the muscle lengthens while developing tension.

Using the same example as above the muscle works to slowly lower the weight against the force of gravity.

The muscle fibres (specifically the sarcomeres) lengthen in an eccentric manner to prevent the weight crashing to the ground.

In rotator cuff strength exercises the muscles often act eccentrically as the weight slowly returns to the exercise starting point to begin the next concentric (shortening) action.

Eccentric action during this "recovery" phase adds significantly to the total work muscles do during any exercise repetition.

It has been shown quite clearly that combined concentric and eccentric muscle actions increase the effectiveness of resistance training.

This in turn leads to not only enhanced muscle strength but also enhanced muscle fibre size.

The final thing to note is that studies have shown that combined eccentric and concentric training is much more effective at preserving strength gains.

Isometric muscle action

Isometric muscle action occurs when a muscle generates force and attempts to shorten but cannot overcome the external resistance. From a physics standpoint this type of action does not produce any external work.

Despite this an isometric or static action can generate substantial force. This is despite any noticeable lengthening or shortening of the muscle fibres (sarcomeres) or any subsequent joint movement.

You just try lifting a house! No matter how much effort you put in that house is simply not going to move. Your muscles will be working hard but there will be no muscle contraction or lengthening. There will be no joint movement either. Despite this lack of movement you will have had a workout.

The video below shows a very simple example of Isometric muscle action. Again using the bicep muscle you can see clearly that in all three phases that the muscles are working hard supporting the bar. Despite this there is no muscle lengthening shortening or joint movement.

In another section entitled "Rotator cuff tear rehabilitation" I go on to discuss rotator cuff strength exercises in more detail. Rotator cuff strengthening is for me the final part of rotator cuff healing.

It is also the beginning of a commitment to avoid any future rotator cuff problems. I give an explanation of Progressive Resistance Exercise that should be the building block of future rotator cuff strengthening.

After trying various products and solutions over the years, my personal tried and trusted recommendations to assist you with your cuff strengthening are the TheraBand resistance bands, which are excellent and the only ones endorsed by the American Physical Therapy Association (APTA), as well as the Altus Athletic Dumbbell Set, the best and most economical of its breed out there.